MEDICARE: UCHENNA IHEANYI OKEKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP030232	RI

General Provider Information

NPI Number	:	1437982303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UCHENNA IHEANYI OKEKE

Provider Business Mailing Address
First Line	:	2002 WOODBRIDGE LN
Second Line	:
City	:	PENNSBURG
State	:	PA
Zip	:	18073-1248
Country	:	US
Telephone Number	:	97-892-5226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 WOODBRIDGE LN
Second Line	:
City	:	PENNSBURG
State	:	PA
Zip	:	18073-1248
Country	:	US
Telephone Number	:	609-789-2522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2024
Last Update Date	:	08/24/2024

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